Cancers which occur in the region of the head and neck (excluding the brain) are termed as Head and Neck Cancers. Over 80 per cent of these cancers arise from the inner epithelial lining of the upper aero-digestive tract (the upper part of the food and air passages).
They include oral, throat and sinus cancers. These are generally related to lifestyle habits, specifically, the use of tobacco and alcohol. The remaining 20 per cent of head and neck cancers are cancers of the thyroid, salivary glands, lymphomas, sarcomas and skin cancers and are not lifestyle related. India has one of the highest incidences of head and neck cancers in the world. Around four lakh such cancers are newly diagnosed here every year.
Causes
Over two thirds of head and neck cancers are related to tobacco abuse. Studies show that chronic exposure to tobacco in any form induces changes in the cells that lead to the development of cancer.
While smokers have a higher risk of lung and throat cancer, those who chew tobacco run an increased risk of cancer of the mouth, throat and food passages. It is no surprise therefore that the country has one of the highest incidences of oral cancer in the world (over 10 per cent of all cancers).
Warning signs
* Ulcer or growth in the mouth
* Persistent change in voice or difficulty to swallow
* Abnormal lump or swelling in the head and neck region
* Blood in sputum or saliva
* A mole or wart which increases in size or starts itching or bleeding
Treatment
Head and Neck cancers are easily curable in their early stages. Even in the advanced stages, many of them are still curable with proper treatment. The main modalities of treatment are surgery, radiation therapy and chemotherapy. These may be used in isolation or in combination depending on the site and stage of the cancer.
Surgery is the main modality of treatment for oral cancers and some advanced cancers of the larynx and pharynx as well as cancers of the thyroid and salivary glands. Radiation therapy is mainly used for early and intermediate stage aero-digestive tract cancers as well as advanced cancers which are surgically inoperable.
Chemotherapy is primarily used in lymphomas and in combination with radiotherapy in advanced aero-digestive cancers of the head and neck. It is also sometimes used before surgery to reduce the size of the tumour and make it more manageable during surgery.
KICK THE BUTT
While a lot has been said about head and neck cancers, few people realise that all it takes to prevent this potentially, life-threatening ailment are a few lifestyle changes. Statements like quit smoking or give up drinking alcohol may sound preachy, but truth is they can go a long way in preventing head and neck cancers.
There are several commercial preparations available in the market that can help smokers kick the habit. But what one really needs is a genuine interest to quit and will power. Other addictions such as alcohol and drugs are physical addictions and on abrupt cessation, produce withdrawal symptoms. Smoking on the other hand is a psychological dependence with no serious side-effects due to abrupt cessation.
Regular examination can detect early cancers where treatment strategies are most effective. Screening programmes can also be used for counselling regarding the potential risk factors.
The writer is consultant Head and Neck Oncologist, Apollo Cancer Hospital, Hyderabad.